Essentia Health West Duluth Pharmacy

LBN: The Duluth Clinic Ltd
Essentia Health West Duluth Pharmacy is an health care organization with primary practice located at 4212 Grand Ave Suite A, Duluth MN 55807-2737. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. The Duluth Clinic Ltd can be contacted via phone (218) 786-3700, or through Boren, Kevin via phone (218) 786-1009.

Contact Information

Primary practice address
4212 Grand Ave Suite A Duluth MN 55807-2737
Phone: (218) 786-3700
Fax: (218) 786-3705
Website:
Map and Directions
Authorized official contact:
Name: Boren, Kevin
Phone: (218) 786-1009

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 261243 Minnesota

Profile Details

NPI number 1427164839
LBN Legal business name The Duluth Clinic Ltd
DBA Doing business as Essentia Health West Duluth Pharmacy
Authorized official Boren, Kevin
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 21st, 2006
Last updated Feb 29th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427164839 NPPES
Minnesota Other 24-16572 NCPDP
Minnesota Other 573 NCPDP
Minnesota MEDICAID 210558600 NCPDP
Minnesota MEDICAID 33050700 NCPDP

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